Vaccination Schedule for Children and Adolescents in Brazil

1 Vaccination Schedule for Children and Adolescents in Brazil Ot vio Augusto Leite Cintra1. IntroductionVaccination is one of the most effective actions in preventive medicine, whether in collective medicine or even at individual level. There is a rapid increase in the prevention of diseases through Vaccination . Health professionals must always be up-to-date as immunization schedules are often modifi ed. All health professionals must know which vaccines are to be recommended. Even more importantly, a vaccine should not be omitted without a sound scientifi c foundation.

2 When speaking about prevention of disease, always remember that this is an important part of the appointment, and the physician should spend some time talking about vaccines, as they are indicated in all age present article will briefl y discuss the most relevant aspects of the Vaccination schedules of the Brazilian Society of Pediatrics and the Brazilian Society of Immunizations to help you when talking to your patients about SchedulesThe Vaccination schedules are general recommendations for the use of vaccines, based on the rationale of each vaccine, and there can be variations between different institutions and countries.

3 It should be stressed that the Schedule can be modified according to specific needs, and a specialist can help in establishing individualized schedules. Tables 1 and 2 present a summary of the Vaccination schedules of the Brazilian Society of 1. Vaccination Schedule up to 15 years of Society of ImmunizationsAge VaccineObservationsBirthHBV + BCGid2 monthsDTaP + Hib + HBV + IPV + PnC7V + RotavirusDTaP or DTP, IPV or OPV Hexavalent3 monthsMnCC4 monthsDTaP + Hib + IPV + PnC7V + RotavirusDTaP or DTP; IPV or OPVP entavalent5 monthsMnCC6 monthsDTaP + Hib+ HBV + IPV + PnC7V + InfluenzaDTaP or DTP.

4 IPV or OPVH exavalent7 monthsInfluenza + MnCC (1)9 monthsYellow feverBooster every 10 years35 VI IAPO MANUAL OF PEDIATRIC OTORHINOLARYNGOLOGY 12 monthsSCR (MMR) + Varicella (2) + HAV15 monthsDTaP + Hib + IPV + PnC7V + MnC DTaP or DTP; IPV or OPVP entavalent18 monthsHAV5 yearsDTaP + SCR + Varicella (2)9 yearsHPV3 doses with a 2 months interval between the 1st and the 2nd dose and 4 months between the 2nd and the 3rd dose15 yearsDTaPNational Immunization DayOPVS tart after 6 months of ageTable 2. Vaccine abbreviations AbreviationVaccine AvailabilityPublic Vaccination clinicsPrivate Vaccination clinics BCGidIntradermal tuberculosis vaccineYesYesHBVH epatitis B vaccineYesYesDTPT riple bacterial vaccine Diphtheria, Tetanus and Pertussis whole cellYe sYe sDTaPTriple bacterial vaccine Diphtheria, Tetanus and Pertussis acellular (isolated B.)

5 Pertussis antigens)No(CRIE)Ye sHibConjugate vaccine Haemophilus influenzae type bYe sYe sPnC7 VPneumococcal conjugate vaccine with 7 serotypesNo(CRIE)Ye sMcCCMeningococcal group C conjugate vaccine No(CRIE)Ye sOPVA ttenuated oral polio vaccineYesYesIPVI nactivated injectable polio vaccineNo(CRIE)Ye sMMRV iral triple vaccine measles, mumps, and rubella Ye sYe sHAVH epatitis A vaccine No(CRIE)Ye sdtapTriple bacterial vaccine Diphtheria, Tetanus and Pertussis acellular (isolated B. pertussis antigens))NoYes36VI IAPO MANUAL OF PEDIATRIC OTORHINOLARYNGOLOGY HexavalentCombined hexavalent vaccine DTaP + Hib + IPV + Hepatitis BNoYesPentavalent Combined pentavalent vaccine DtaP + Hib + IPVNoYesTetravalent Combined vaccine DTP + HibYesNoHPVT etravalent vaccine against human papillomavirus serotypes 6, 11, 16 and 18 (HPV)Ye sN oObservations1.

6 DtaP, Hib, IPV and Hepatitis B vaccines should be preferably given in their combined form (HEXA) thus eliminating the second dose of Hepatitis B vaccine with one month of age, reducing the number of The meningococcal group C conjugate vaccine (Neisseria meningitidis) can be given at two months of age. For convenience reasons, however, it is included in the Vaccination Schedule at three months. There are three products presently available:a. MnCC conjugate vaccine from Wyeth, with mutant diphtheria protein (CRM197);b. MnCC conjugate vaccine from Novartis, with mutant diphtheria protein (CRM197);c.

7 De-O-Acetylated MnCC conjugate from Baxter, with tetanic of the manufacturers vaccines can be used in two-dose schedules in the first year of age, followed by one booster dose after 12 months of age. If Vaccination is started after the child is one year old, all vaccines can be given as a single dose, according to Table 3 presented below. Each of the manufacturers vaccines can be used in two-dose schedules in the first year of age, followed by one booster dose after 12 months of age. If Vaccination is started after the child is one year old, vaccines can be given as a single dose, according to Table 3 presented 3.

8 Vaccination Schedule according to the manufacturer:VaccineAgeDosesStarting atRouteWyeth and Novartis0 to 11 months2 + 1 booster3 months of ageIMBaxter0 to 11 months2 + 1 booster2 months of ageIMAny manufacturer> 1 year1 Single doseIMThe booster of a pneumococcal conjugate vaccine given after one year of age is essential to ensure a prolonged protection. This recommendation was included in the Vaccination Schedule this year, as the consolidation of this vaccine results in the United Kingdom showed a decreased efficacy in Children after four years of age when they received only three doses of the vaccine in the first year of life.

9 It is not recommended to delay the Vaccination after the first year of life, as the 37 VI IAPO MANUAL OF PEDIATRIC OTORHINOLARYNGOLOGY incidence of meningococcal disease in Brazil is high during this The whole-cell (DTP) and acellular (DtaP) Bordetella pertussis vaccines are presently available. They have a similar efficacy, but DtaP is associated with less reactivity and is available in the combined The oral polio vaccine (OPV) with live attenuated virus has a risk of paralysis of 1 per 750,000 to million administered doses, but this does not occur with the inactivated vaccine (IPV).

10 Besides this important advantage, IPV also requires a lower number of doses and waste is reduced. With IPV being combined with other vaccines, this option becomes more advantageous and is therefore recommended. OPV should be maintained in the National Immunization Days and can be given to all Children who received The influenza vaccine ( flu vaccine ) is recommended for all healthy Children from six to 59 months of age, as this is the age group with highest risk for more severe infections by this virus. It is recommended for other age groups to avoid an infection by this agent.